by Sam Amick, USA TODAY Sports

by Sam Amick, USA TODAY Sports

The path to an NBA title just got a whole lot harder for the Oklahoma City Thunder - again.

More than five months after point guard Russell Westbrook tore the meniscus in his right knee at the start of the Thunder's playoff run, he had arthroscopic surgery on the same knee Tuesday morning and is expected to miss the first four to six weeks of the regular season that starts Oct. 30.

While Westbrook was not experiencing pain in the knee, swelling persisted and led to a trip to California on Monday to have the knee examined. As Thunder general manager Sam Presti detailed on a conference call with reporters, the medical group that recommended the latest procedure was different from the one from Vail, Colo., that did the initial surgery on Westbrook's meniscus.

During the arthroscopic surgery, a loose stitch was discovered that was the origin of the swelling. Presti, who deemed the loose stitch an "outlier," said the Thunder's team physicians "were present as observers" for the meniscus procedure and the arthroscopic surgery.

The good news for the Thunder - and there isn't much - is two-fold: It's better to solve this swelling mystery now rather than learn of the loose stitch midway through the season, and Presti said the doctors were also able determine during the Tuesday procedure that the meniscus is fully healed. But the bad news - and there is plenty - is that the Thunder were already losing their grip on their spot among the Western Conference elite.

After losing shooting guard/third-leading scorer Kevin Martin to the Minnesota Timberwolves via free agency over the summer, Kevin Durant's load now will be even heavier than it was during the Westbrook-less playoff run in which Oklahoma City fell to the Memphis Grizzlies in five games during the second round. Third-year point guard Reggie Jackson will likely start in Westbrook's spot, though the Thunder re-signed veteran point guard Derek Fisher as well. Second-year shooting guard Jeremy Lamb, by default, is an even more vital piece of this puzzle than before despite the fact that he has just 23 games of NBA experience.

Presti took the optimistic route during his conference call, addressing the many questions that surround their latest setback.

On the silver-lining regarding the meniscus: "We're very, very encouraged to be able to say that the meniscus itself is healed, and healed as well as could have been expected," Presti said.

On why they did the arthroscopic procedure now: "We thought it was important to identify the source of the swelling as well because we didn't want to be in a position where we're faced with this decision in an on-again, off-again situation as the season progressed," Presti said.

On the current mind-set for Westbrook, who had never missed a game in high school, college, or nearly five seasons in the NBA before the meniscus injury: "He's a very, very smart guy," Presti said. "He understands that, although there's some loss of time here - a small amount from what was initially forecasted - what was gained was a tremendous amount of confidence in the healing of the knee. â?¦ I think he understands that this bodes well for him, not only for this season but with the foreseeable future with the Thunder."

On who will fill his role at the point guard spot: "I think that's something that has to be determined by the coaching staff," Presti said. "As we talked about before, we've been in this situation unfortunately where we've had to play without him in the past. I think that we'll be more prepared, knowing a lot more about our team and some of the players who were able to perform at the time that we were dealing with this particular situation in the past."

On the long-term outlook for Westbrook and the Thunder: "I think that over time, as we work through this period, when Russell does come back and joins us, A) he'll be as good as ever, and B) I believe that the team will be better than the one he last played with, based on the fact that they're going to have to play through some situation that are not necessarily the way that we expected them," Presti said. "I've got a lot of confidence in our staff and in our players to make those adjustments."